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257 S Lincoln Way Galt CA 95632-1711 | |
| (209) 745-3484 | |
| (209) 714-2739 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 257 S Lincoln Way, Galt, California |
| Authorized Official Name and Position | Uma Zykofsky (DEPUTY DIRECTOR) |
| Authorized Official Contact | 9168759904 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7001a East Pkwy Suite 400 Sacramento CA 95823-2501 Ph: (916) 875-4948 | 257 S Lincoln Way Galt CA 95632-1711 Ph: (209) 745-3484 |
| NPI Number | 1407922024 |
|---|---|
| Provider Enumeration Date | 11/27/2006 |
| Last Update Date | 09/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407922024 | NPI | - | NPPES |
| 8483 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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